New modes in non-invasive ventilation

Rabec, Claudio; Émériaud, Guillaume; Amadeo, Alessandro; Fauroux, Brigitte; Georges, Marjolaine

doi:10.1016/j.prrv.2015.10.004

Cited by 15 publications

(32 citation statements)

References 75 publications

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“…There is a growing but still limited data on the use and safety of NIV NAVA in premature infants. Most of the previously reported studies like our current study had small patient population ranging from 5 to 15 [18,20,22]. The NIV NAVA mode as used in our study seems to be effective as well as safe compared to the other existing noninvasive modes in premature infants.…”

Section: Discussionmentioning

confidence: 49%

Electrical Activity of the Diaphragm in a Small Cohort of Preterm Infants on Noninvasive Neurally Adjusted Ventilatory Assist and Continuous Positive Airway Pressure: A Prospective Comparative Pilot Study

Gupta

Lumba

Bailey

et al. 2019

Cureus

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Objective: To compare the electrical activity of the diaphragm (Edi) of premature infants placed on continuous positive airway pressure (CPAP) with the Edi of premature infants placed on noninvasive neurally adjusted ventilatory assist (NIV NAVA). The secondary aim was to evaluate the feasibility of the use of NIV NAVA mode in the busy tertiary neonatal unit. Study Design: This was a prospective crossover pilot study of premature infants requiring noninvasive respiratory support. Infants were randomized to initially receive either CPAP/biphasic (group 1) or NIV NAVA (group 2) and were then crossed over to the alternate group. Continuous Edi signals were recorded for 24 h, with 12 h each on CPAP/biphasic, and NIV NAVA along with other clinical and respiratory parameters. Results: Ten infants with a mean gestation age of 29 weeks (range 25-34 weeks) were enrolled, with a total cumulative Edi monitoring of 240 h. The average Edi peak on the biphasic/CPAP group (15.6 ± 7 mcV) was significantly higher (P < 0.005), compared to the Edi Peak on the NIV NAVA group (10.8 ± 3.3 mcV). The Edi min values were 3.23 ± 1.1 mcV, and 3.07 ± 0.5 mcV on CPAP/biphasic and NIV NAVA (P = 0.69) respectively. There were no significant differences in other clinical parameters between the two groups. No major adverse events were recorded during Edi catheter monitoring. Conclusion: The Edi peak values were significantly lower in NIV NAVA mode compared to CPAP/biphasic mode. The Edi catheter and NIV NAVA may also be used safely in premature infants.

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Section: Discussionmentioning

confidence: 49%

Electrical Activity of the Diaphragm in a Small Cohort of Preterm Infants on Noninvasive Neurally Adjusted Ventilatory Assist and Continuous Positive Airway Pressure: A Prospective Comparative Pilot Study

Gupta

Lumba

Bailey

et al. 2019

Cureus

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“…In NIV, pressure-targeted (controlled) mode is the most often used due to its ability to compensate for leaks and to generate constant pressures when compared with volume-targeted ventilation ( 8 , 9 ).…”

Section: Types Of Ventilatormentioning

confidence: 99%

“…The risk of rebreathing is reduced by using a baseline expiratory positive pressure. In some bi-level ventilators, expiratory pressure cannot be set below 3 or 4 cmH 2 O to assure that the circuit is adequately flushed ( 4 , 8 , 9 ).…”

Section: Types Of Ventilatormentioning

confidence: 99%

“…The newest bi-level ventilators allow the clinician to indicate the interface used during NIV ( 9 ). This feature allows the device to better identify intentional and unintentional leaks so that the flow can be adjusted to guarantee desired performances.…”

Section: Types Of Ventilatormentioning

confidence: 99%

“…Bi-level ventilators work properly in the presence of certain amount of leaks that may vary between devices. Leaks that impair proper trigger or cycle functioning must be considered as unacceptable ( 9 ).…”

Section: Types Of Ventilatormentioning

confidence: 99%

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Ventilators and Ventilatory Modalities

et al. 2020

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Non-invasive ventilation is increasingly used in children for acute and chronic respiratory failure. Ventilators available for clinical use have different levels of complexity, and clinicians need to know in detail their characteristics, setting variables, and performances. A wide range of ventilators are currently used in non-invasive ventilation including bi-level ventilators, intermediate ventilators, and critical care ventilators. Simple or advanced continuous positive airway pressure devices are also available. Differences between ventilators may have implications on the development of asynchronies and air leaks and may be associated with discomfort and poor patient tolerance. Although pressure-targeted (controlled) mode is preferable in children because of barotrauma concerns, volume-targeted (controlled) ventilators are also available. Pressure support ventilation represents the most used non-invasive ventilation mode, as it is more physiological. The newest ventilators allow the clinicians to use the hybrid modes that combine the advantages of volume- and pressure-targeted (controlled) ventilation while limiting their drawbacks. The use of in-built software may help clinicians to optimize the ventilator setting as well as to objectively monitor patient adherence to the treatment. The present review aims to help the clinician with the choice of the ventilator and its ventilation modalities to ensure a successful non-invasive ventilation program.

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